Provider Demographics
NPI:1558536722
Name:RAWCZAK, REBECCA DYSTE (MSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:DYSTE
Last Name:RAWCZAK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:RUTH
Other - Last Name:DYSTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:250 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6132
Mailing Address - Country:US
Mailing Address - Phone:425-365-5118
Mailing Address - Fax:
Practice Address - Street 1:250 MARKET ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6132
Practice Address - Country:US
Practice Address - Phone:425-365-5118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical